Thank you for replying. I wish it were SCC or basal cell carcinoma of the scalp-- that would make MOHS surgery possible, and also skin graft rather than free flap. It isn't certain that they will use radiation, but likely. A skin graft would fail if radiated. One surgeon will open the scalp with one to two inch margins (which means a large oval probably seven to eight inches in the long dimension) and the other will reconstruct the scalp with a free flap, insuring a blood supply. I suspect they will use my left latissimus muscle. Between excision and reconstruction they will remove all visible cancerous tissue, and I assume will use a microscopic tool in doing so. That tissue will allow a more thorough pathological study.

They are fairly certain that it is this pleomorphic dermal sarcoma. I can't find any sarcoma support group nor head and neck support group that mentions it. There is a general sarcoma group on Facebook. I can find two case studies which discuss the procedures, and I can also find statements that it is very rare and possibly aggressive

Thank you, I will let you know how it goes. I'm scheduled for the surgery on August 22.

best wishes, Jon Angel